There are many many many websites and YouTube videos that claim there is a
condition called estrogen dominance where the hormones are out of balance.
Is it real? Does it cause infertility? Can it be
treated to improve fertility? Stay tuned and find out.
First the basics
Normally, after puberty women start ovulating. An egg matures in the ovary and is released
This process is essential to produce a pregnancy naturally. You can divide the
cycle into two parts: Before and After ovulation. The part before ovulation is
called the Follicular Phase because the eggs develop in a small cyst called a follicle.
When the egg is maturing, the cells that make up the follicle are
growing in size and number. These follicle cells are also producing a
hormone called estradiol, which most people refer to as estrogen, but it's
really just one type of estrogen. During the follicular phase estrogen starts out
low and increases as the follicle grows. This estrogen is necessary to start
thickening the uterine lining. After ovulation, the estrogen doesn't change
all that much, but another hormone called progesterone starts to increase.
This is called the luteal phase. Progesterone is produced in pulses, but generally
increases until about a week after ovulation. Progesterone transforms the
uterine lining to make it receptive to an embryo. If a pregnancy has not
happened, then the levels of both estrogen and progesterone start dropping.
The drop in both hormones eventually results in a period.
What is "Estrogen Dominance"?
Well, a group of scam artists called naturopaths argue, without any
scientific evidence, that people have an imbalance when there is too much estrogen
and not enough progesterone. On its face, this argument makes no sense.
In women who ovulate, the levels of these hormones is changing. let's look at
a couple of different time points during the ovulatory cycle.
First, the early follicular phase. If you measure blood
estrogen levels in the first few days after the period starts they run about
10 to 40 picograms per milliliter. At the same time, progesterone levels run
about 100 to 900 picograms per milliliter. So at this point of the cycle
there is roughly 10 times more progesterone than estrogen. What about in
the late follicular phase, just prior to ovulation? At this point the amount of
estrogen is between 200 and 300 pg/mL. But progesterone hasn't changed.
Progesterone is still 10 times higher
Now, if we go to the middle of the luteal phase, about a week past ovulation
now the estrogen is still between 200 and 300 pg/mL
but now progesterone has increased to about 10,000 to 20,000 pg/mL
There is never going to be a point during the ovulatory cycle where
the amount of estrogen is out of balance with progesterone. It's all perfectly
synchronized to prepare the uterine lining for an embryo. But wait a minute
Dr. Morris!! My doctor told me my progesterone level is too low and told
me I needed to take extra progesterone to get pregnant. How do you explain that?
First, the measurement of progesterone is really hard. Like I said before,
progesterone is produced in pulses. Progesterone is like the weather here in Chicago.
Don't like it? Just wait 15 minutes it'll change!
Nonetheless, a lot of doctors will tell their patients to take progesterone after ovulation if
their level is below some arbitrary level usually less than 10,000 pg/mL.
or simply "10". However, this practice has virtually no scientific
evidence that it improves the chance for a natural pregnancy. There is a little
bit of evidence that it might reduce slightly the risk of miscarriage in
women who have had at least three unexplained miscarriages.
By the way, if you ovulate, there is no scientific proof that anything can be done to increase
progesterone level naturally. Our InfertilityTV Bottom Line is this
#1 Estrogen dominance does not exist!!
#2 Treating estrogen dominance, hormone imbalance or progesterone deficiency
will not increase your chance for pregnancy.
#3 Taking progesterone supplements may reduce your risk for miscarriage
slightly if you've had three or more unexplained miscarriages previously.
One final thing, I highly recommend this book by Edzard Ernst. Here is a guy who was
hired by a university to study alternative medicine scientifically
so they could determine which ones were valid and offer them to their patients
After 25 years of study, he found that nearly all of these supposed therapies
are, well, scams. If you liked this video remember to like this video. Have an idea
for a future episode? Leave it in the comments. InfertilityTV releases a new
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